Dr. Komrokji on the Current Treatment Landscape in MDS

Rami Komrokji, MD, professor, Medicine and Oncologic Sciences, College of Medicine, University of South Florida, senior member, Malignant Hematology and Experimental Therapeutics Program, and head of the Leukemia and MDS Section, Moffitt Cancer Center, discusses the current treatment landscape in myelodysplastic syndrome (MDS).

Hypomethylating agents (HMAs) such as azacitidine and decitabine have been the frontline standard of care for patients with MDS for over a decade, says Komrokji. While these agents improve survival and delay leukemic transformation, they are only active in about half of patients with MDS for around 1 year.

Allogeneic stem cell transplantation (allo-SCT), the only curative option for patients with MDS, is typically reserved for patients with higher-risk disease, explains Komrokji. Many patients with MDS are ineligible for allo-SCT due to disease risk, age, or comorbidities.

Patients with high-risk disease, including those with p53 mutations, tend to have poor survival despite treatment with HMAs or intensive chemotherapy, Komrokji says.

Future research efforts should focus on improving response rates and the durability of response with HMAs, as well as developing novel agents for patients who progress on HMAs, concludes Komrokji.